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Biopsychosocial predictors of short-term success among people with low back pain referred to a physiotherapy spinal triage service

BACKGROUND: A spinal triage assessment service may impact a wide range of patient outcomes. Investigating potential predictors of success or improvement may reveal why some people improve and some do not, as well as help to begin to explain potential mechanisms for improvements. The objective of thi...

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Autores principales: Bath, Brenna, Lovo Grona, Stacey
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4412484/
https://www.ncbi.nlm.nih.gov/pubmed/25960675
http://dx.doi.org/10.2147/JPR.S81485
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author Bath, Brenna
Lovo Grona, Stacey
author_facet Bath, Brenna
Lovo Grona, Stacey
author_sort Bath, Brenna
collection PubMed
description BACKGROUND: A spinal triage assessment service may impact a wide range of patient outcomes. Investigating potential predictors of success or improvement may reveal why some people improve and some do not, as well as help to begin to explain potential mechanisms for improvements. The objective of this study was to determine which factors were associated with improved short-term self-reported pain, function, general health status, and satisfaction in people undergoing a spinal triage assessment performed by physiotherapists. METHODS: Participants with low back-related complaints were recruited from people referred to a spinal triage assessment program (N=115). Participants completed baseline questionnaires covering a range of sociodemographic, clinical, and psychological features. Self-reported measures of pain, function, quality of life, and satisfaction were completed at 4 weeks following the assessment. Determination of “success” was based on minimal important change scores of select outcome measures. Multivariate logistic regression was used to explore potential predictors of success for each outcome. RESULTS: Despite the complex and chronic presentation of most participants, some reported improvements in outcomes at 4 weeks post assessment with the highest proportion of participants demonstrating improvement (according to the minimal important change scores) in the Medical Outcomes Survey 36-item short-form version 2 physical component summary score (48.6%) and the lowest proportion of participants having improvements in the Numeric Pain Rating Scale (11.5%). A variety of different sociodemographic, psychological, clinical, and other variables were associated with success or improvement in each respective outcome. CONCLUSION: There may be a potential mechanism of reassurance that occurs during the spinal triage assessment process as those with higher psychological distress (measured by the Fear Avoidance Beliefs Questionnaire and the Distress and Risk Assessment Measure) were more likely to improve on certain outcomes. The use of an evaluation framework guided by a biopsychosocial model may help determine potential mechanisms of action for a physiotherapy-delivered triage program.
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spelling pubmed-44124842015-05-08 Biopsychosocial predictors of short-term success among people with low back pain referred to a physiotherapy spinal triage service Bath, Brenna Lovo Grona, Stacey J Pain Res Original Research BACKGROUND: A spinal triage assessment service may impact a wide range of patient outcomes. Investigating potential predictors of success or improvement may reveal why some people improve and some do not, as well as help to begin to explain potential mechanisms for improvements. The objective of this study was to determine which factors were associated with improved short-term self-reported pain, function, general health status, and satisfaction in people undergoing a spinal triage assessment performed by physiotherapists. METHODS: Participants with low back-related complaints were recruited from people referred to a spinal triage assessment program (N=115). Participants completed baseline questionnaires covering a range of sociodemographic, clinical, and psychological features. Self-reported measures of pain, function, quality of life, and satisfaction were completed at 4 weeks following the assessment. Determination of “success” was based on minimal important change scores of select outcome measures. Multivariate logistic regression was used to explore potential predictors of success for each outcome. RESULTS: Despite the complex and chronic presentation of most participants, some reported improvements in outcomes at 4 weeks post assessment with the highest proportion of participants demonstrating improvement (according to the minimal important change scores) in the Medical Outcomes Survey 36-item short-form version 2 physical component summary score (48.6%) and the lowest proportion of participants having improvements in the Numeric Pain Rating Scale (11.5%). A variety of different sociodemographic, psychological, clinical, and other variables were associated with success or improvement in each respective outcome. CONCLUSION: There may be a potential mechanism of reassurance that occurs during the spinal triage assessment process as those with higher psychological distress (measured by the Fear Avoidance Beliefs Questionnaire and the Distress and Risk Assessment Measure) were more likely to improve on certain outcomes. The use of an evaluation framework guided by a biopsychosocial model may help determine potential mechanisms of action for a physiotherapy-delivered triage program. Dove Medical Press 2015-04-23 /pmc/articles/PMC4412484/ /pubmed/25960675 http://dx.doi.org/10.2147/JPR.S81485 Text en © 2015 Bath and Lovo Grona. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Original Research
Bath, Brenna
Lovo Grona, Stacey
Biopsychosocial predictors of short-term success among people with low back pain referred to a physiotherapy spinal triage service
title Biopsychosocial predictors of short-term success among people with low back pain referred to a physiotherapy spinal triage service
title_full Biopsychosocial predictors of short-term success among people with low back pain referred to a physiotherapy spinal triage service
title_fullStr Biopsychosocial predictors of short-term success among people with low back pain referred to a physiotherapy spinal triage service
title_full_unstemmed Biopsychosocial predictors of short-term success among people with low back pain referred to a physiotherapy spinal triage service
title_short Biopsychosocial predictors of short-term success among people with low back pain referred to a physiotherapy spinal triage service
title_sort biopsychosocial predictors of short-term success among people with low back pain referred to a physiotherapy spinal triage service
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4412484/
https://www.ncbi.nlm.nih.gov/pubmed/25960675
http://dx.doi.org/10.2147/JPR.S81485
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